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IntroductionResearch examining the influence of neighborhood healthy food environment on diet has been mostly cross-sectional and has lacked robust characterization of the food environment. We examined longitudinal associations between features of the local food environment and healthy diet, and whether associations were modified by race/ethnicity.MethodsData on 3634 adults aged 45-84 followed for 10 years were obtained from the Multi-Ethnic Study of Atherosclerosis. Diet quality was assessed using the Alternative Healthy Eating Index at Exam 1 (2000-2002) and Exam 5 (2010-2012). We assessed four measures of the local food environment using survey-based measures (e.g. perceptions of healthier food availability) and geographic information system (GIS)-based measures (e.g. distance to and density of healthier food stores) at Exam 1 and Exam 5. Random effects models adjusted for age, sex, education, moving status, per capita adjusted income, and neighborhood socioeconomic status, and used interaction terms to assess effect measure modification by race/ethnicity.ResultsNet of confounders, one standard z-score higher average composite local food environment was associated with higher average AHEI diet score (β=1.39, 95% CI: 1.05, 1.73) over the follow-up period from Exam 1 to 5. This pattern of association was consistent across both GIS-based and survey-based measures of local food environment and was more pronounced among minoritized racial/ethnic groups. There was no association between changes in neighborhood environment and change in AHEI score, or effect measure modification by race/ethnicity.ConclusionOur findings suggest that neighborhood-level food environment is associated with better diet quality, especially among racially/ethnically minoritized populations.

ObjectiveTo examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality.DesignCross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income.SettingUrbanised areas in multiple regions of the USA, years 2000-2002 and 2010-2012.ParticipantsParticipants aged 45-84 years were followed for 10 years (n 3567).ResultsMedian HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46).ConclusionsRestaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

Using data from the Multi-Ethnic Study of Atherosclerosis baseline sample from 2000 to 2002 (N=5263; mean age=62) we examined cross-sectional racial/ethnic differences in ideal CVH, defined by the American Heart Association 2020 Impact Goals as a summary measure of ideal levels of blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking. Using three different analytical approaches, we examined differences before and after adjustment for neighborhood socioeconomic, physical, and social environments. Significant racial/ethnic differences were present for all indicators of ideal CVH (excluding physical activity). Additional adjustments for neighborhood factors produced modest reductions in racial/ethnic differences. Future research is necessary to better understand the impact of neighborhood context on health disparities using longitudinal study designs.

Cardiovascular disease (CVD) continues to be the leading cause of death and a major source of health disparities in the Unites States and globally. Efforts to reduce CVD risk and eliminate cardiovascular health disparities have increasingly emphasized the importance of the social determinants of health. Neighborhood environments have emerged as a possible target for prevention and policy efforts. Hence there is a need to better understand the role of neighborhood environments in shaping cardiovascular risk. The MESA (Multi-Ethnic Study of Atherosclerosis) Neighborhood Study provided a unique opportunity to build a comprehensive place-based resource for investigations of associations between specific features of neighborhood physical and social environments and cardiovascular risk factors and outcomes. This review summarizes the approaches used to characterize residential neighborhood environments in the MESA cohort, provides an overview of key findings to date, and discusses challenges and opportunities in neighborhood health effects research. Results to date suggest that neighborhood physical and social environments are related to behavioral and biomedical risk factors for CVD and that cardiovascular prevention efforts may benefit from taking neighborhood context into account.

Purpose: The aim of this study was to examine trends in the prevalence of no leisure-time physical activity (LTPA) from 1988 to 2010. Method: Using the Behavioral Risk Factor Surveillance System data, 35 states and the District of Columbia reported information on no LTPA from 1988 to 1994; all states reported no LTPA from 1996 to 2010. Results: No LTPA significantly declined over two decades. Prevalence for all states declined on an average of 0.6% per year from 29.1% in 1996 to 24.1% in 2004 and stabilized from 2005 to 2010, ranging from 24.0% to 25.4%. Prevalence declined for both sexes and all racial/ethnic groups. Conclusion: While the no LTPA trends improved over two decades, one in four U.S. adults still report they do not engage in LTPA. (Contains 2 figures.)

Objectives. We investigated associations between local food environment and neighborhood racial/ethnic and socioeconomic composition. Methods. Poisson regression was used to examine the association of food stores and liquor stores with racial/ethnic composition and income in selected census tracts in North Carolina, Maryland, and New York. Results. Predominantly minority and racially mixed neighborhoods had more than twice as many grocery stores as predominantly White neighborhoods (for predominantly Black tracts, adjusted stores per population ratio [SR]=2.7; 95% confidence interval [CI]=2.2, 3.2; and for mixed tracts, SR=2.2; 95% CI=1.9, 2.7) and half as many supermarkets (for predominantly Black tracts, SR=0.5; 95% CI=0.3, 0.7; and for mixed tracts, SR=0.7; 95% CI=0.5, 1.0, respectively). Low-income neighborhoods had 4 times as many grocery stores as the wealthiest neighborhoods (SR=4.3; 95% CI=3.6, 5.2) and half as many supermarkets (SR=0.5; 95% CI=0.3, 0.8). In general, poorer areas and non-White areas also tended to have fewer fruit and vegetable markets, bakeries, specialty stores, and natural food stores. Liquor stores were more common in poorer than in richer areas (SR=1.3; 95% CI=1.0, 1.6). Conclusions. Local food environments vary substantially by neighborhood racial/ethnic and socioeconomic composition and may contribute to disparities in health. doi:10.2105/AJPH.2004.058040)

The article discusses the findings of the 2019 Behavioral Risk Factor Surveillance system (BRFSS) data which estimated the percentage of adults in the U.S. who met fruit and vegetable intake recommendations. Topics covered include the low percentage of U.S. adults meeting the recommendations, the state-specific percentage of respondents meeting federal recommendations, by sex, age, race/ethnicity, and income-to-poverty ratio, and the implications of the report for public health practice.

Background: Street-scale urban design policies are recommended to increase physical activity in communities. Our purpose was to examine U.S. public support for local street-scale urban design features and policies. Methods: Analysis is based on a cross-sectional national sample of adults (n = 4682) participating in the 2006 HealthStyles mail survey. Results: About 57% of adults rated local street-scale urban design as highly important in determining the amount of physical activity they obtain. Adjusted odds of rating neighborhood features as having high importance were higher in people aged ≥65 years versus those <65 and minority racial/ethnic groups versus non-Hispanic whites. Two-thirds of adults were willing to take civic action to support local street-scale urban design policy. Adjusted odds of being willing to take any action versus none was higher in non-Hispanic blacks and Hispanics versus non-Hispanic whites, was higher in those with household incomes ≥$60,000 versus ≤$15,000 per year, and increased as education and perceived importance of neighborhood features increased. Conclusions: There are high levels of public support for local street-scale urban design policies; however, demographic differences exist in the level of support. These differences are important considerations for policymakers and for those designing community programs targeting street-scale urban design features and policies. [ABSTRACT FROM AUTHOR]

Background: We estimated percentages of US adults (≥18 years) who knew that prior federal physical activity (PA) guidelines call for a minimum of 30 minutes of moderate-intensity PA most days(≥5)/week using 2003 to 2005 HealthStyles, an annual mail survey, Methods: 10,117 participants identified "the minimum amount of moderate-intensity PA the government recommends to get overall health benefits?' Response options included 30/≥5, 20/≥3, 30/7, and 60/7 (minutes/days per week), "none of these," and "don't know." The odds of correctly identifying the guideline was modeled by participant sex, age, race/ethnicity, income, education, marital status, body mass index, physical activity level, and survey year using logistic regression. Results: 25.6% of respondents correctly identified the guideline. Women were 30% more likely to identify the guideline than men (Odds Ratio [95% Confidence Limits[ (OR) = 1.28 [I.15, 1.44]). Regular PA was positively associated with identifying the guideline versus inactivity (OR = 2.08 [I.73, 2.50]). Blacks and those earning <$15,000 annually were 24% to 32% less likely to identify the guideline than whites and those earning >$60,000, respectively. Conclusions: Most adults did not know the previous moderate-intensity PA recommendation, which indicates a need for effective communication strategies for the new 2008 Physical Activity Guidelines for Adults. [ABSTRACT FROM AUTHOR]